A nonsurgical treatment of peri‐implantitis using mechanic, antiseptic and anti‐inflammatory treatment: 1 year follow‐up

Abstract

Aims The study's aim was to assess the clinical outcome 6 and 12 months after a nonsurgical treatment of peri‐implantitis per se or in conjunction with a combination of local antiseptic and anti‐inflammatory treatment. Materials and methods Included were 69 patients with periodontitis, with 106 implants, diagnosed with peri‐implantitis. Peri‐implantitis was defined as radiographic bone loss ≥3 mm, probing depth (PD) ≥ 6 mm, with bleeding on probing. Group M peri‐implantitis was treated with ultrasonic debridement and soft tissue curettage. Group P had additional implant surface treatment with rotatory hand piece composed of chitosan bristle, soft tissue curettage combined with application of 0.95% hypochlorite and 1 mg minocycline HCl. Results After 6 months, both groups demonstrated significant reduction of mean plaque index, PD, and clinical attachment level (0.71 ± 0.57, 0.81 ± 0.55; 4.77 ± 0.73 mm, 4.42 ± 0.5 mm; 5.03 ± 0.86 mm, 5.13 ± 0.73 mm; respectively) and bleeding on probing. After 6 and 12 months, group P showed significantly better PD results compared to group M. The bleeding was significantly less in group P after 12 months (15.3% ± 6.2, 25.1% ± 8.2, respectively). Conclusions Adjunctive treatment with local antiseptic and anti‐inflammatories during mechanical phase was positively associated with inflammation reduction and connective tissue reattachment.

Nonsurgical Treatment of Peri-Implantitis: Case Series

“…Under peri-implantitis, now we recognize plaque-associated pathological condition of peri-implant tissues, characterized by inflammatory process of mucosa and progressive bone loss near the dental implants, and can be defined by the identification of several signs such as bleeding or suppuration during careful probing and progressive of peri-implant bone loss beyond the crestal ridge due to initial bone remodeling. In the absence of all these signs, the diagnosis can be provided according the combination of the following criteria: depth of probing not less than 6 mm, appearance of bleeding or suppuration during this measurement test, and the bone loss level with apical direction not less than 3 mm in comparison to coronal intraosseous part of dental implant [6][7][8]. Now, the prevalence of peri-implantitis is higher than it was considered before: during the first 10 years after dental implantation, it varies from 1% to 47% according to a systematic review of Derks and Tomasi (2015) and even about 85% in the work of Dreyer (2018) [9,10], especially in conditions of comorbidity, poor oral hygiene, and bad habits like smoking.…”

Preventing Peri-implantitis: The Quest for a Next Generation of Titanium Dental Implants

“…242 More effectively, adjunctive approaches where antibiotics or antibacterial agents, such as chlorhexidine, are employed in addition to the debridement methods. 243,244 Surgical therapy for peri-implantitis can be done through various techniques such as simple access flaps for cleaning, apically repositioned flap and access flap and bone recontouring or regenerative procedures with plaque control. 238,245 When a complete biofilm removal is not possible with one treatment, then a combination of treatments may be performed.…”

“…However, these mechanical debridement methods have failed to affect pocket depths and reduce bacterial counts in peri-implantitis. , Laser (or photodynamic) and air-abrasive devices have also been used; however long-term effects of these nonsurgical methods remain uncertain . More effectively, adjunctive approaches where antibiotics or antibacterial agents, such as chlorhexidine, are employed in addition to the debridement methods. , Surgical therapy for peri-implantitis can be done through various techniques such as simple access flaps for cleaning, apically repositioned flap and access flap and bone recontouring or regenerative procedures with plaque control. , When a complete biofilm removal is not possible with one treatment, then a combination of treatments may be performed . In general, the strategy is to dilute (the inoculum size), disrupt (the biofilm) and detoxify (the implant).…”

Ibero‐Panamerican Federation of Periodontics Delphi study on the trends in diagnosis and treatment of peri‐implant diseases and conditions: A Latin American consensus

“…19 Recently, some studies have shown that macrophage phenotype and specific interleukins may play an important role in disease pathogenesis and progression of peri-implantitis [38][39][40] and, therefore, future trends to treat peri-implantitis may involve antiinflammatory agents to modulate inflammation and counteract peri-implant tissue destruction. [41][42][43]…”